Highlights
- •Coronary ED is associated with insulin resistance.
- •Coronary ED is also associated with impairments in insulin secretory response.
- •Decreases in LDL particle size, not the total LDL-Ch, influences coronary ED.
- •Coronary ED is also influenced by impaired fibrinolysis.
Abstract
Aims
This study was aimed to compare insulin sensitivity and secretion response, lipoprotein
and plasminogen activator inhibitor 1 (PAI-1) levels between the subjects with and
without coronary artery endothelial dysfunction (ED).
Methods
ED was detected by intracoronary injection of acetylcholine (ACh) in 47 nondiabetes
subjects without stenotic coronary arteries, selected from 316 consecutive patients
with coronary angiography performed for suspected coronary artery disease. The subjects
were divided into two groups: presence of ACh-induced coronary spasm (group ED+, N = 30)
and absence of ACh-induced coronary spasm (group ED−, N = 17). Insulin sensitivity
(Si) was evaluated by frequently sampled intravenous glucose tolerance test (FSIGTT)
with minimal model analysis and by HOMA-IR, insulin secretion by acute insulin response
(AIR) (calculated from the first 8 min of FSIGTT) and by disposition index (DI) (Si × AIR).
Lipids and PAI-1 levels were determined enzymatically, and LDL particle size by gradient
gel electrophoresis.
Results
Si was significantly lower (4.22 ± 0.62 vs 6.98 ± 1.47 min−1/mU/l × 104; p < 0.05) while HOMA-IR was significantly higher in ED + group vs ED− group (2.8 ± 0.3
vs 1.7 ± 0.2; p < 0.05). Simultaneously, AIR and DI was significantly lower in ED + vs
ED− groups (p < 0.05 and p < 0.01, respectively). Investigated groups did not differ
in fasting lipid levels but ED+ group had significantly smaller LDL particles (p < 0.01)
and higher PAI-1 levels (p < 0.05). Regression analysis shown that DI was a strong
independent predictor of appearance of ED, together with PAI-1 and LDL particle size.
Conclusions
Both insulin resistance and impairment in insulin secretion response strongly correlate
with coronary ED in subjects without diabetes.
Keywords
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Article info
Publication history
Published online: March 08, 2018
Accepted:
March 2,
2018
Received in revised form:
February 25,
2018
Received:
January 12,
2018
Identification
Copyright
© 2018 Elsevier B.V. All rights reserved.
